Duodenal gastrointestinal stromal tumors: clinicopathological characteristics, surgery, and long-term outcome

Shen, Chaoyong; Chen, Hai‐Ning; Yin, Yuan; Chen, Jiaju; Han, Luyin; Zhang, Bo; Chen, Zhuo; Chen, Jiaping

doi:10.1186/s12893-015-0084-3

Cited by 38 publications

(38 citation statements)

References 32 publications

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“…Lymph node metastasis was found only in 2 of our patients, and liver metastasis was found only in one patient. Our study showed a high proportion of low-mitotic-rate tumors (≤5/50 high-power field; 63.3%); this result agreed with that of a previous report [18].…”

Section: Discussionsupporting

confidence: 83%

“…Among all of our patients with duodenal GISTs, the 5-year OS and PFS rates for those with duodenal adenocarcinoma were 89.1 and 72.9%, respectively, which is consistent with previous reports [18,37]. However, in the DOI: 10.1159/000488008…”

Section: Discussionsupporting

confidence: 80%

“…The median tumor size in our study was 5.0 cm, which is similar to that reported by a previous study [18]. For GISTs, the tumor could grow expansively to a very large size and have a high T stage but rarely metastasizes to regional lymph nodes or distant organs [19].…”

Section: Discussionsupporting

confidence: 79%

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Clinicopathological Characteristics, Surgical Treatments, and Survival Outcomes of Patients with Duodenal Gastrointestinal Stromal Tumor

et al. 2018

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Background: Duodenal gastrointestinal stromal tumors (GISTs) are rare and their clinicopathological features have not been completely described. In this retrospective study, we examined the characteristics and long-term outcomes of patients who underwent surgical treatment for duodenal GISTs. Methods: We examined patients surgically treated for duodenal GISTs from 1999 to 2016 at the China National Cancer Center. We analyzed patient characteristics, treatments, histological examinations, and survival outcomes. Results: The 52 surgeries performed included 14 pancreaticoduodenectomies (26.9%), 37 limited resections (71.2%), and one palliative bypass procedure (1.9%). No surgery-related death occurred. The complication rate in patients who underwent pancreaticoduodenectomy was slightly higher than that in patients who underwent limited resection. The 5-year overall survival and progression-free survival rates for patients with duodenal adenocarcinoma were 89.1 and 72.9%, respectively. The overall survival and progression-free survival rates were not significantly related to surgical methods. Large tumor size and high mitotic rate were associated with poor overall survival outcomes. However, no independent factor was associated with prognosis, which may be due to the small sample size. Conclusion: The prognosis of duodenal gastrointestinal stromal tumors was good. Limited resection seems to be oncologically feasible, with outcomes being less worse than those of pancreaticoduodenectomy.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 80%

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Clinicopathological Characteristics, Surgical Treatments, and Survival Outcomes of Patients with Duodenal Gastrointestinal Stromal Tumor

et al. 2018

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“…In multivariate analysis, only the mitotic count was an independent risk factor for adverse prognosis. DGIST is a tumor with favorable prognosis after radical resection, which is similar to other institutions [29]. Long-term follow-up should be recommended for patients with DGIST.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological and Prognostic Features of Surgical Management in Duodenal Gastrointestinal Stromal Tumors

Shi¹,

Huang²,

Wang³

et al. 2017

Dig Surg

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Background and Objectives: The rarity of duodenal gastrointestinal stromal tumors (DGIST) led to only limited data being available on their management and prognosis. We retrospectively analyzed the clinicopathological features, surgical treatments, adjuvant therapy, and prognosis of DGIST. Methods: Sixty-one patients were identified at diagnosis of primary DGIST from February 2005 to December 2015. One hundred twenty six patients with small intestinal gastrointestinal stromal tutors (GIST) were selected as control groups. Survival analyses were calculated using the Kaplan-Meier method. Results: Three- and five-year recurrence/metastasis-free survival rates of patients with DGIST were similar to those of patients with small intestinal GIST (p > 0.05 for all). Out of 61 cases with DGIST, 45 patients were treated with Limited Resection (LR). Sixteen patients were treated with Pancreaticoduodenectomy (PD). The 3- and 5-year recurrence/metastasis-free survival rates of the PD group and LR group were of no significant difference (p > 0.05 for all). Univariate analysis indicated that factors including surgical approaches, mitotic count, size, and risk grades were significantly associated with recurrence/metastasis-free survival (log-rank test, p < 0.05). Multivariate analysis demonstrated that the mitotic count was independently correlated with a worse recurrence/metastasis-free survival. Conclusions: Patients with radical resected DGIST had a favourable prognosis, which is similar to that of small intestinal GIST. Both LR and PD were optimal choices for treating DGIST.

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“…Most dGISTs develop in the second (59-63%) and third portion (22%) of duodenum (55,106), whereas the first and forth are less frequently affected. GIST of ampulla Vateri is extremely rare and according to the review of Kobayashi et al only 12 cases have been described till 2014 (30).…”

Section: Localizationmentioning

confidence: 99%

Surgical treatment of gastrointestinal stromal tumors of the duodenum: a literature review

Popivanov¹,

Tabakov²,

Mantese³

et al. 2018

Transl. Gastroenterol. Hepatol

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Background: Gastrointestinal stromal tumors (GIST) are the most frequent mesenchymal tumours in the digestive tract. The duodenal GIST (dGIST) is the rarest subtype, representing only 4-5% of all GIST, but up to 21% of the resected ones. The diagnostic and therapeutic management of dGIST may be difficult due to the rarity of this tumor, its anatomical location, and the clinical behavior that often mimic a variety of conditions; moreover, there is lack of consent for their treatment. This study has evaluated the scientific literature to provide consensus on the diagnosis of dGIST and to outline possible options for surgical treatment.Methods: An extensive research has been carried out on the electronic databases MEDLINE, Scopus, EMBASE and Cochrane to identify all clinical trials that report an event or case series of dGIST.Results: Eighty-six studies that met the inclusion criteria were identified with five hundred forty-nine patients with dGIST: twenty-seven patients were treated with pancreatoduodenectomy and ninety-six with only local resection (segmental/wedge resections); in four hundred twenty-six patients it is not possible identify the type of treatment performed (pancreatoduodenectomy or segmental/wedge resections).Conclusions: dGISTs are a very rare subset of GISTs. They may be asymptomatic or may involve symptoms of upper GI bleeding and abdominal pain at presentation. Because of the misleading clinical presentation the differential diagnosis may be difficult. Tumours smaller than 2 cm have a low biological aggressiveness and can be followed annually by endoscopic ultrasound. The biggest ones should undergo radical surgical resection (R0). In dGIST there is no uniformly adopted surgical strategy because of the low incidence, lack of experience, and the complex anatomy of the duodenum. Therefore, individually tailored surgical approach is recommended. R0 resection with 1-2 cm clear margin is required. Lymph node dissection is not recommended due to the low incidence of lymphatic metastases. Tumor rupture should be avoided.

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Duodenal gastrointestinal stromal tumors: clinicopathological characteristics, surgery, and long-term outcome

Cited by 38 publications

References 32 publications

Clinicopathological Characteristics, Surgical Treatments, and Survival Outcomes of Patients with Duodenal Gastrointestinal Stromal Tumor

Clinicopathological Characteristics, Surgical Treatments, and Survival Outcomes of Patients with Duodenal Gastrointestinal Stromal Tumor

Clinicopathological and Prognostic Features of Surgical Management in Duodenal Gastrointestinal Stromal Tumors

Surgical treatment of gastrointestinal stromal tumors of the duodenum: a literature review

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